During pregnancy, the hormone progesterone plays an important role. On the one hand, it immobilizes the uterus, and on the other hand, the pregnancy-protective hormone also dampens the movement of the stomach, gallbladder, esophagus, small intestine and large intestine. These restrictions eventually lead to a range of gastrointestinal symptoms. Frequently, nausea – especially in the morning -, bloating, as well as vomiting occur in early pregnancy as a result of the slowed intestinal activity. Since the tension of the muscle ring at the end of the esophagus is reduced, stomach acid can enter the esophagus and cause irritation and discomfort. Heartburn – predominantly in late pregnancy – is the result.
Recommendations to relieve nausea, bloating, vomiting and heartburn:
- Frequent, small and meals throughout the day, they are less stressful for the stomach and intestines.
- Sleep with the upper body elevated
- Do not eat anything three hours before bedtime, avoid spicy foods
- Prefer whole grains, fresh fruits and vegetables; dried fruits, such as prunes and figs are considered natural laxatives for constipation
- Nuts, almonds or a teaspoon of medium hot mustard helps with heartburn
- Abundant fluid intake, in the form of water or herbal tea, about 40 ml/kg body weight daily.
- Sufficient but not excessive exercise
- Optimization of the supply of vital substances (micronutrients) stimulates intestinal activity and increases the mobility of the esophageal and gastric muscles – increased intake of vitamin B6, calcium, magnesium, coenzyme Q10, omega-3 fatty acids and fiber.
Increased progesterone secretion is also responsible for constipation common in pregnancy as a result of intestinal sluggishness and increased dehydration of the stool. A diet rich in fiber and plenty of fluids as well as sufficient exercise can prevent constipation. In this way, hemorrhoids can also be counteracted, which are also among the pregnancy complaints.
Changing eating patterns with a growing craving for certain foods – pickles, chocolate, fruits, cheese and ice cream – which occur mainly between the 4th and 7th month, can also lead to digestive problems. In addition, one-sided diets can develop from the changes in eating habits, which then cause significant vital substance (micronutrient) deficiencies. Some pregnant women often experience ravenous hunger, which leads them to eat indiscriminately and uncontrollably.
In about 2% of all pregnancies, hyperemesis gravidarum develops, whereby the pregnant woman suffers from vomiting and nausea that cannot be controlled, resulting in disturbances in electrolyte balance, high water and electrolyte losses, weight loss, and insufficient coverage of nutrient and vital substance requirements (macro- and micronutrients). This serious clinical picture requires intensive outpatient or inpatient treatment. If the severe vomiting cannot be influenced by drugs, artificial nutrition to correct the water and electrolyte balance and to eliminate the increased ketone body concentration (ketosis) is beneficial.
From mid-pregnancy onwards, calf cramps may occur more frequently if hypocalcemia (calcium deficiency) and a phosphate increase as well as pantothenic acid deficiency and hypomagnesemia (magnesium deficiency) are present. Such cramps can be significantly improved by oral magnesium administration over four weeks. In particular, those affected should pay more attention to an increased intake of calcium, magnesium and vitamin B5. Some pregnant women suffer from itching (pruritus gravidarum) due to the estrogen-induced disturbance of bile flow, which is caused by the deposition of nonsulfated bile acid in the skin.
